This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Periphal arterial disease (PAD) is a prevelent illness that affects 12% of U.S. adults. Diabetes mellitus is one of the strongest atherosclerotic risk factors for this disease. Among patients with diabetes mellitus who are age 50 years or older, the prevelence of AD is as high as 29%. As an atherosclerotic illness, risk factor modification is a core component in the management of PAD. An additional and underutilized component of care is exercise therapy. While any form of exercise, including isometric exercise (e.g. weightlifting), can be used to modify athersclerotic risk factor profiles, walking has specifically been shown to benefit functional status in patients with symptomatic PAD. The purpose of this study is to determine if self-managed walking therapy results in improved ambulatory function for patients with symptomatic PAD and diabetes mellitus. Specifically, the hypothesis for this study is that patients with symptomatic PAD with diabetes mellitus who are randomized to self-managed walking therapy plus routine care have better ambulatory function at 6 months when compared to patients who are randomized to an attention-control group.